How Far Has CPR Feedback Come?

Meeting Advances in Resuscitation Science

截至2019年1月31日，美国心脏协会（AHA）需要在教授成人心肺复苏（CPR）技能的所有课程中使用仪器的指示反馈设备。这American Red Cross implemented the same initiativein their training courses in January 2018.

CPR feedback has come a long way since the development of the world’s first CPR manikin. Prior to 1960, many methods that would be considered unusual by today’s standards were used to treat victims of sudden cardiac arrest. Intuitively, people knew that there was something that could be done to revive victims – and then science proved them right. Here’s a look at the history of CPR feedback through the lens of the most recognizable and “most kissed” woman in the world – Resusci Anne.

Photo: Resusci Anne featured on The Today Show in 1973.

1960年代

1960年，詹姆斯·裘德（James Jude）博士，威廉·库文霍夫（William Kouwenhoven）博士和G. Guy Knickerbocker在美国医学协会杂志on “closed-chest cardiac massage,” which evolved into cardiopulmonary resuscitation (CPR).¹几年后，即1963年，美国心脏协会（AHA）正式认可CPR。²

Developed by Asmund S. Laerdal, together with Dr. Safar and Dr. Bjorn Lind, Resusci Anne became the world’s first CPR training manikin. Resusci Anne provided real-time feedback for quality CPR training. Dials indicated correct ventilation and compressions.

照片：1968年发表的有关Resusci Anne的文章。

1970年代

In 1972, the world’s first mass CPR training program began in Seattle, certifying more than 100,000 people in the first two years.³西雅图继续强调旁观者的参与和培训使其成为心脏骤停的最安全地方之一。⁴

录音Resusci Anne帮助通过印刷性能反馈训练Laypeople。纸条提供了通风和压缩质量的视觉表示。

Photo: Rosalynn Carter performing compressions on the Recording Resusci Anne at the White House.

1980年代

一项为CPR提供电话指示的计划始于华盛顿的金县。紧急调度员向呼叫者提供了指示，而消防部门和紧急医疗技术人员（EMTS）则在前往现场的途中。现在在美国各地，调度员辅助CPR很普遍，调度员必须持有有效的CPR认证。⁵

Laerdal recognized that quality CPR has a very different outcome than just any CPR. SkillMeter Resusci Anne was designed to meet the growing need for quantitative real-time CPR measurement and feedback. She used advanced electronics to display CPR technique and sequence of steps.

Photo:许多调度员开始培训以使用高质量的心肺复苏术SkillMeterResusci Anne.

1990年代

Public Access Defibrillation programs began placing automated external defibrillators (AEDs) in public places and providing training to the public.⁶快速除颤对于增加SCA的生存至关重要，如今几乎可以在所有公共设施中找到AED。

Resusci Anne Skillguide具有基本的CPR反馈。Laerdal开发了CPR-D版本，该版本允许进行广泛的模拟自动外部除颤（AED）训练。SkillGuide设备和Skillreporter打印机作为免费反馈选项提供。

Photo:NASA宇航员的玛格丽特·瑞亚·塞登（Margaret Rhea Seddon）在1993年进行任务时进行了零重力CPR培训。

2000年代

这American Heart Association and European Resuscitation Council (ERC) guidelines emphasized the importance ofqualityCPR。精度和精度开始在心肺复苏式培训课程中增加重量。

Laerdal PC SkillReporting System was developed to offer an additional feedback option to supplement the SkillGuide device and SkillReporter printer. By the end of the 2000’s, Resusci Anne was a highly-modular manikin offering numerous configurations, accessories, and feedback options.

Photo:SkillReporter打印机用于在执行压缩时同时审查反馈。

2010年

这2010 AHA Guidelines加强了高质量心肺复苏的重要性，但也带来了重大变化。建议的压缩率和深度进行了修改，这要求个人和团队提高其心肺复苏术技能。同时，西雅图的复苏学院（Resuscitiation Academy）在世界各地的最佳实践中培训领导者，以增加心脏骤停的生存。

In 2013, Resusci Anne QCPR was released to improve feedback capabilities and manikin modularity. Resusci Anne QCPR worked with the SimPad platform, which increased the sophistication of CPR debriefing and data analysis. And, in 2015, the addition of冲击链接使Resusci Anne QCPR用户能够将自己的临床除颤器安全地集成到高性能的CPR培训中。

Photo:紧急医疗服务（EMS）参与了他们必须除颤安妮（Resusci Anne）的情况。

今天

Now that the American Red Cross and the AHA have issued mandates that require the use of a direct feedback device in all adult CPR courses, quality CPR training is attainable for everyone- lay people and healthcare providers alike.

在2018年，Resusci Anne QCPR重新设计以提高使用的简单性。最新的增强功能包括蓝牙低能（BLE），以便于连接更加易于连接，可充电电池可提供34小时的移动工作时间以及比以往任何时候都多的反馈设备选项。新的Resusci Anne QCPR与QCPR教练和QCPR学习者应用程序以及CPR兼容Teams，这是Simpad Plus与Skill Reporter的新培训选项。

Photo: EMS professionals training in a realistic environment with their clinical defibrillator.

A Look Forward

Resuscitation training has continued to evolve in the direction of more robust feedback and analytics, effectively removing all “guessing” from the training equation. Now, we are seeing this feedback integrated into downloadable software and apps. The AHA has alsoannouncedthat the adult CPR training requirement will extend to infant and pediatric training in the future.

随着反馈技术的发展，CPR培训也随之发展。据估计，Laerdal的复苏Manikins已被用来培训全球超过5亿人。估计挽救了250万人的生命。我们只能希望这些趋势将继续下去，以便每个学习者都会获得自我效能，以执行挽救生命的心肺复苏术。

照片：与Skill Reporter有关Simpad Plus的高性能CPR团队培训课程的评论.

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参考

美国心脏协会（2015）。CPR时间轴的历史。取自https://news.heart.org/history-of-cpr timeline-text-yly/
Ibid
Ibid
Sudden Cardiac Arrest Foundation (2014). King county, WA, has world’s highest survival rate for cardiac arrest. Retrieved from http://www.sca-aware.org/sca-news/king-county-wa-has-worlds-highest-survival-rate-for-cardiac-arrest
American Heart Association (2018). History of cpr. Retrieved from https://cpr.heart.org/AHAECC/CPRAndECC/AboutCPRECC/HistoryofCPR/UCM_475751_History-of-CPR.jsp
美国心脏协会（2015）。See Reference #1.